(Uncorrected OCR) Abstract of thesis entitled Factors affecting Influenza Vaccination among Non-instutionalized Elderly Persons in Hong Kong Submitted by LAU Lam For the Degree of Master of Medical Science (Geriatric Medicine), Department of Medicine at The University of Hong Kong in August 2005 Background: Influenza vaccination has been confirmed as both clinically and cost-effectively powerful in reducing the mortality and morbidity of elderly from influenza complications in recent studies. In view of the huge public health and economic impacts of influenza, the Hong Kong SAR government has encouraged elderly aged 65 or above to receive influenza vaccination for years. This study aims at exploring the factors that influence Hong Kong elderly persons on influenza vaccine uptake. Study Design: Cross-sectional exploratory study Methods: Members in 15 elderly social canters. (6 NEC and 9 S/E) and patients in Medical and Geriatric Unit and Orthopeadic Unit of Caritas Medical Centre, whom aged 65 or above, were invited to participate in this study. A total of 816 elderly aged 65 or above were recruited within a 5-month period from December 2004 to April 2005. The association between self-reported influenza vaccination status in current year and several sociodemographic, perception, health status, knowledge, source of advice, cognitive, ADL function as well as influence of SARS and Avian Flu outbreak variables was assessed by logistic regression. The associations between self-reported influenza vaccination status in current year and several socio-demographic characteristics, perception, health status, knowledge, source of advice, cognitive and ADL function as well as influence of SARS and Avian flu outbreak variables were assessed by logistic regression. Results: Overall, 62.4% of the subjects have received the influenza vaccine. Using multivariate analysis models, influenza vaccination status is related to several factors, including consideration of vaccination in the following year (OR = 7.877; 95% CI: 4.855-12.782, pO.OOl); consideration vaccination if all elderly aged 65 or above are eligible to receive free vaccination (OR = 3.024; 95% CI: 1.504-6.083, p = 0.002); belief that "there is a need of Influenza vaccination after SARS and Avian Flu" (OR = 2.413; 95% CI: 1.412-4.122, p = 0.001); advice from doctor (OR = 3.771; 95% CI: 2.232-6.369, p<0.001); advice from family or friend (OR = 3.023; 95% CI: 1.610-5.677, p = 0.001) as well as advice from staff of elderly social centre (OR = 7.161; 95% CI: 4.718-10.868, pO.OOl). Conclusion: In Hong Kong, uptake of the influenza vaccine is still suboptimal. This study reveals that the predictors of Hong Kong elderly aged 65 or above on influenza vaccination are similar to the western or Asian counterparts. Influence of outbreaks of SARS and Avian flu in Hong Kong has raised the health awareness of our elderly. However, the cognitive and ADL function of the elderly do not have statistically significant effects on our elderly in their decision on influenza vaccination. Recommendations to improve the elderly's motivation for influenza vaccination include the following means: 1) physicians should give clear and intentional recommendations to patients on influenza vaccination; 2) reminder system to facilitate elderly remembering influenza vaccination; 3) health promotion programme for elderly to improve awareness and reinforce the importance of influenza vaccination; 4) free vaccination programme offered by the Hong Kong SAR government for all elderly aged 65 or above. Only with close collaboration between the government, health professionals, the elderly and their family would our influenza vaccination program be pushed into a true success.